Osteoporosis
- 4th Edition - June 13, 2013
- Latest edition
- Editors: Robert Marcus, David W. Dempster, Jane A. Cauley, David Feldman
- Language: English
Now in its fourth edition, Osteoporosis is a classic reference on this disease, comprising a tremendous wealth of knowledge in a single source not found elsewhere. Written by ren… Read more
Now in its fourth edition, Osteoporosis is a classic reference on this disease, comprising a tremendous wealth of knowledge in a single source not found elsewhere. Written by renowned experts in the field, this two-volume work is a must-have for academic and medical libraries, physicians, researchers, and any company involved in osteoporosis research and development. This newest edition covers everything from basic anatomy and physiology to diagnosis, management and treatment in which direct care costs for osteoporotic fractures in the United States reach up to $18 billion each year. Worldwide, 200 million women ages 60 to 80 suffer from osteoporosis and have a lifetime risk of fracture between 30% and 40%, continuing to make osteoporosis a critical challenge in medicine.
- Recognizes the critical importance of the Wnt signaling pathway for bone health
- Incorporates new chapters on osteocytes, phosphatonins, mouse genetics, and CNS and bone
- Examines essential updates on estrogen prevention and treatment and the recent results from the WHO
- Discusses the controversial topics of screening and clinical trial design for drug registration
- Includes essential updates on therapeutic uses of calcium, vitamin D, SERMS, bisphosphonates, and parathyroid hormone
- Offers critical reviews of reproductive and hormonal risk factors, ethnicity, nutrition, therapeutics, management, and economics
Academic and medical libraries as well as professionals in bone biology, endocrinology, osteology, neuroendocrinology; drug companies developing osteoporosis medications
Preface to the Fourth Edition
Contributors
Editor’s Note
Part I: Introduction
Chapter 1. The Bone Organ System: Form and Function
Introduction
Composition and Organization of Bone
Cellular Components of Bone
Bone Homeostasis
Basic Bone Mechanics
Summary
References
Chapter 2. The Nature of Osteoporosis
Defining Osteoporosis
Material and Structural Basis of Skeletal Fragility
Summary
References
Chapter 3. Reflections on Osteoporosis
Introduction
Definition
Diagnosis
Fragility Fractures
Bone Density and Fracture Risk
Pathogenesis
Prevention
Treatment
Summary
References
Chapter 4. Reflections on Development of Concepts of Intercellular Communication in Bone
Introduction
Calcium Homeostasis – Developments of the 1960s
Discovery of Calcitonin
Inhibition of Bone Resorption by Calcitonin
Lessons from an Osteogenic Sarcoma
Emergence of Bone Cell Biology
Could Osteoblasts Regulate Osteoclasts?
The Origin of Osteoclasts – Mid-1970s
Osteoblast Regulation of Osteoclasts
Control of Osteoclast Formation
Hormone and Cytokine Control of Osteoclast Formation
The Physiologic Signaling Mechanisms in Osteoclast Control
Bone Remodeling
Coupling of Bone Formation to Resorption
Coupling Factor – from Matrix or Cells?
Communication from Osteocytes
Is There a Single “Coupling Factor”, Analogous to RANKL?
PTHrP as a Local Control Process
How Might PTHrP Participate?
Summary
Acknowledgments
References
Chapter 5. Osteo-Odyssey: A Memoir
Starting Out: From A to B One
Being the First Postdoc in Larry’s Lab
In the Academic World: Projects and People
The Bone World Beyond the Laboratory: ASBMR and NOF
References
Part II: Cellular, Molecular, and Developmental Biology of Bone
Chapter 6. Development of the Skeleton
Overview
Patterning the Skeleton
Endochondral Bone Formation
Signaling Pathways that Regulate Endochondral Bone Formation
Intramembranous Bone Formation
References
Chapter 7. The Skeletal Stem Cell
Introduction
Defining Skeletal Stem Cells
Migration of Skeletal Stem Cells
Kinetics of Skeletal Cell Turnover
Potential Use of Skeletal Stem Cells as Therapy
Interactions with the Hematopoietic System
Summary
References
Chapter 8. Osteoclast Biology
Introduction
Osteoclast Formation
Osteoclast Function
Conclusions
Acknowledgments
References
Chapter 9. Osteoblast Biology
Overview
Phenotypic Properties of Osteogenic Lineage Cells
Developmental Sequence of Osteoblast Phenotype Development
Markers of Osteoblast Maturation Stages
Genetic and Epigenetic Control of Gene Expression Regulating Skeletal Biology and Pathology
Concluding Remarks
Acknowledgments
References
Chapter 10. Osteocyte Biology
Introduction
Osteocyte Ontogeny
Osteoid-Osteocytes
Osteocyte Selective Genes/Proteins and Their Potential Functions
Morphology of Osteocytes: Lacunocanalicular System and Dendrite Formation
Osteocyte Cell Models
Mechanisms and Response of Osteocytes to Mechanical Forces
Osteocyte Signals for Bone Formation
Osteocyte Signals for Bone Resorption
Osteocyte Apoptosis and Autophagy
Osteocyte Modification of Their Microenvironment
Osteocyte Regulation of Phosphate Metabolism
Role of Gap Junctions and Hemichannels in Osteocyte Communication
Osteocytes in the Embryonic and the Adult Skeleton
The Implications of Osteocyte Biology for Bone Disease
Conclusions
Acknowledgment
References
Chapter 11. The Regulatory Role of Matrix Proteins in Mineralization of Bone
Introduction
Collagenous Proteins
Intermediate Cartilage Matrix
Osteoadherin, Keratocan, and Lumican
Bone-Enriched Matrix Proteins
Alkaline Phosphatase
Osteonectin
RGD-Containing Glycoproteins
Osteocalcin
Matrix Gla Protein
Periostin
The Mineralization of Bone Matrix
Acknowledgments
References
Part III: Skeletal Hormones and Regulatory Factors
Chapter 12. Parathyroid Hormone and Parathyroid Hormone-Related Protein
Introduction
Synthesis and Secretion of Parathyroid Hormone
Metabolism of Parathyroid Hormone
Bone-Resorbing Action of Parathyroid Hormone
Effects of PTH on Bone Formation
Renal Actions of Parathyroid Hormone
Parathyroid Hormone-Related Protein as a Mediator of Humoral Hypercalcemia of Malignancy
Physiological Roles of Parathyroid Hormone-Related Protein
Mechanism of Action of Parathyroid Hormone and Parathyroid Hormone-Related Protein
Acknowledgments
References
Chapter 13. Vitamin D: Biology, Actions, and Clinical Implications
Introduction
Vitamin D: Synthesis and Metabolism
Pathways of Activation and Inactivation of Vitamin D
Mechanism of 1,25(OH)2D Action
Nongenomic Actions of Vitamin D
Genetic Disorders
1,25(OH)2D3 Analogs
Action of Vitamin D in Classical Target Organs to Regulate Mineral Homeostasis
Actions of 1,25(Oh)2D in Nonclassical Target Organs
Vitamin D and Osteoporosis
References
Chapter 14. Regulation of Bone Cell Function by Estrogens
Introduction
Estrogen Biosynthesis
Estrogen Receptors
Activities in Bone Attributable to Estrogen Receptor α and/or Estrogen Receptor β
Estrogen Receptor Pharmacology
Summary
References
Chapter 15. Androgens and Skeletal Biology: Basic Mechanisms
Introduction
Androgens and the Role of Androgen Metabolism
Cellular Biology of the Androgen Receptor in the Skeleton
The Consequences of Androgen Action In Bone Cells
The Skeletal Effects of Androgen: Animal Studies
Animal Models of Altered Androgen Responsiveness
The Role of Androgen Receptors Versus Aromatization of Testosterone
Androgen Deficiency and Bone Loss: Similarities Between Animal Models and Humans at a Clinical Level
Summary
References
Chapter 16. Phosphatonins
Introduction
Phosphorus Homeostasis
Phosphatonins
Fibroblast Growth Factor-23
Secreted Frizzled-Related Protein 4
Matrix Extracellular Phosphoglycoprotein (MEPE)
Fibroblast Growth Factor 7
Summary
References
Chapter 17. Skeletal Growth Factors
Introduction
Platelet-Derived Growth Factor
Vascular Endothelial Growth Factor
Fibroblast Growth Factor
Transforming Growth Factor Beta
Bone Morphogenetic Proteins
Insulin-Like Growth Factor
Insulin-Like Growth Factor Binding Proteins
Hepatocyte Growth Factor
Acknowledgments
References
Chapter 18. WNT Signaling in Skeletal Homeostasis and Diseases
Introduction
Wnt Signaling
Wnt Signaling in Skeletal Development, Homeostasis, and Diseases
Wnt Signaling Interacts with Other Pathways in Bone Mass Regulation
Wnt Signaling and Mechanical Loading
Targeting the Wnt Pathway for Therapeutic Intervention
Summary
References
Part IV: Skeletal Structure and Biomechanics
Chapter 19. The Mechanical Behavior of Bone
Introduction
Introduction to Bone Mechanics
Role of Bone Composition and Microstructure on Bone Mechanical Properties
Mechanical Behavior of Whole Bone
Age-Related Changes in Bone Mechanics that Contribute to Fracture
Summary
References
Chapter 20. Cellular and Molecular Mechanotransduction in Bone
Introduction
Bone Mechanotransduction
Forms of Mechanical Stimulation – Tissue Mechanics
Cellular and Pericellular Mechanics
Mechanosensing Mechanisms
Mechanically Activated Intracellular Signaling Pathways
Cell–cell Pathways that are Activated or Mediate Effects of Mechanical Stimuli
Conclusion and Implications for Osteoporosis
References
Chapter 21. Adaptation of Skeletal Structure to Mechanical Loading
Introduction and Background
Diaphyseal Compact Bone
Cancellous Bone
Toward a More Mechanistic Understanding of Functional Adaptation in Bone
Conclusion
References
Chapter 22. Biomechanics of Hip and Vertebral Fractures
Introduction
Biomechanics of Hip Fractures
Biomechanics of Vertebral Fractures
Summary and Clinical Implications
References
Chapter 23. Prevention of Osteoporosis by Physical Signals: Defining a Potential Role for Nondrug Strategies in the Treatment of Musculoskeletal Injury and Disease
Introduction
Bone’s Sensitivity to Mechanical Signals
Structural Demands on the Skeleton
Regulation of Bone Morphology by Physical Signals
Anabolic Potential of Low-magnitude Mechanical Signals
Regulating the Bone Cell Response to Mechanical Signals
Translating Mechanobiology to the Clinic
Summary
Acknowledgments
References
Part V: Epidemiology of Osteoporosis
Chapter 24. Epidemiologic Methods in Studies of Osteoporosis
Introduction
Descriptive and Analytic Studies
Study Designs in Analytical Epidemiologic Studies
Some Useful Epidemiologic Concepts
Frequently Used Statistics
Criteria for Deciding whether an Association Matters
Sample Size Considerations
Measurement Error
Discrepant Results Between Studies Examining Similar Research Questions
Summary
Acknowledgments
References
Chapter 25. Genetic Determinants of Osteoporosis
Introduction
Finding Risk Gene Variants for Complex Traits
Identifying Osteoporosis Risk Gene Variants
Applications and Prospects
References
Chapter 26. Race, Ethnicity, and Osteoporosis
Introduction
Background and Definitions
Ethnoepidemiology of Osteoporosis
Summary
References
Chapter 27. Geographic Variability in Hip and Vertebral Fractures
Introduction
Hip Fractures
Vertebral Fractures
Conclusion
Acknowledgements
References
Chapter 28. Nutrition and Risk for Osteoporosis
Introduction
Problems in the Investigation of Nutritional Effects on Bone
The Notion of A Nutrient Requirement
The Natural Intake of Calcium and Vitamin D
Calcium
Vitamin D
Protein
Vitamin K
Other Essential Nutrients
Conclusion
References
Chapter 29. Physical Activity and Exercise in the Maintenance of the Adult Skeleton and the Prevention of Osteoporotic Fractures
Introduction
The Adult Skeleton and Aging
Theoretical Basis for Physical Activity and Exercise
Physical Activity/Exercise Modes
Exercise and Pharmacological Agents
Exercise and Fracture Rates
Exercise Prescription Recommendations
Conclusions
References
Chapter 30. Premenopausal Reproductive and Hormonal Characteristics and the Risk for Osteoporosis
Introduction
Pregnancy
Age at First Pregnancy
Parity and Nulliparity
Lactation
Ovarian Activity or Menstrual Cycle Characteristics and Bone Mass
Dysfunctional Ovulation
Oral Contraceptive Use
Progestin-Injectable Contraceptives
Oophorectomy
Summary and Implications
References
Chapter 31. Clinical and Epidemiological Studies: Skeletal Changes across Menopause
Introduction
Methodological Issues in Studying Menopause
Pathophysiology of Skeletal Changes at Menopause
Changes in Bone Density across Menopause
Bone Structure/Size Changes
Bone Turnover
Mechanisms Underlying Bone Loss at Menopause
Fracture Risk
Summary
References
Chapter 32. Osteoporosis in Men: Epidemiology, Pathophysiology, and Clinical Characterization
Fractures in Men
The Incidence of Fractures
The Determinants of Fracture
The Major Determinants of Skeletal Health in Men
Age-Related Bone Loss
Causes of Age-Related Bone Loss
Osteoporosis
The Evaluation of Osteoporosis in Men
Acknowledgements
References
Chapter 33. Falls as Risk Factors for Fracture
Introduction
Risk Factors for Falls
Risk Factors for Injurious Falls
Falls Prevention Strategies
Methodologic Approaches to Analyzing Falls
Summary and Implications
References
Chapter 34. Nonskeletal Risk Factors for Osteoporosis and Fractures
Introduction
Physical Characteristics
Anthropometric Variables
Lifestyle Factors
References
Chapter 35. Outcomes Following Osteoporotic Fractures
Introduction
Definition
Risk of Refracture
Risk of Mortality
Fracture Burden
Conclusion
References
Part VI: General Pathophysiology of Osteoporosis
Chapter 36. Skeletal Heterogeneity and the Purposes of Bone Remodeling: Implications for the Understanding of Osteoporosis
Introduction
Skeletal Heterogeneity
The Purposes of Bone Remodeling
Implications for Understanding Osteoporosis
References
Chapter 37. On the Evolution and Contemporary Roles of Bone Remodeling
Introduction
The Basics of Bone Remodeling
Skeletal Involvement in Managing Metabolic Imperatives: Roles and Consequences
Calcium, Remodeling, and Skeletal Structure
An Evolutionary Theory on the Origin of Continuous Bone Remodeling
Bone Remodeling and Reproduction
Lactational and Postmenopausal Bone Loss as Antagonistic Pleiotropies
Bone Remodeling, Skeletal Microcracks, and Fatigue Damage
Effects of Remodeling Inhibition on Bone Strength
The Partnership of Bone Remodeling and Modeling
Summary
References
Chapter 38. Cytokines and the Pathogenesis of Osteoporosis
Introduction
Receptor Activator of Nuclear Factor-Kappab Ligand (RANKL), Receptor Activator of Nuclear Factor-Kappab (RANK) and Osteoprotegerin (OPG)
Macrophage Colony-Stimulating Factor
Additional Colony Stimulating Factors
Interleukin-1
Tumor Necrosis Factor
Additional Tumor Necrosis Factor Superfamily Members
Interleukin-6
Additional Interleukin-6 Family Members
Interleukin-8 and Other Chemokines
Interleukin-10
Interleukin 12
Interleukin 15
Interleukin 17, Interleukin 23, and Interleukin 27
Interleukin 18
Interferons
Additional Cytokines
References
Chapter 39. Animal Models for Osteoporosis
Introduction
Goals of Animal Models for Osteoporosis
Specific Animal Models
Mouse
Evaluation of the Osteopenic Skeleton in Animal Models
Fracture Repair
Summary
References
Chapter 40. Bone and Fat
Introduction
Bone and Fat—Epidemiological Studies
Physiology of Adipose Tissue and Energy Expenditure
Adipocytic and Osteoblastic Differentiation
Hormonal Factors that Regulate Bone and Energy Metabolism
Drug-induced Changes in Bone and Fat
References
Chapter 41. Bone Mineral Acquisition in Utero and During Infancy and Childhood
Introduction
Quantitative Assessment of Bone Health in Infants and Children
Bone Acquisition in Utero
Bone Acquisition in the Preterm Infant
Bone Acquisition in Term Infants and Children
References
Chapter 42. Bone Acquisition in Adolescence
Introduction
Measuring Bone Acquisition
Overview of Bone Accrual During Adolescence
Determinants of Bone Acquisition During Adolescence
Summary and Future Directions
References
Chapter 43. Osteoporosis in Childhood and Adolescence
Introduction
Principles of Bone Development
Definition and Diagnosis of Osteoporosis in Children and Adolescents
Pathogenesis and Treatment of Specific Disorders
Summary and Future Directions
References
Chapter 44. Osteoporosis Associated with Pregnancy
Introduction
Calcium Homeostasis
Osteoporosis Associated With Pregnancy
Osteoporosis Associated with Heparin Therapy During Pregnancy
Osteoporosis Associated with Magnesium Sulfate Therapy During Pregnancy
Paradoxical Bone Mineralization in Twin-To-Twin Transfusion Syndrome
Acknowledgments
References
Chapter 45. Osteoporosis in Premenopausal Women
Introduction
Diagnosis of Osteoporosis in Premenopausal Women
Secondary Causes of Osteoporosis in Premenopausal Women
Treatment Considerations for Premenopausal Women with Low Trauma Fractures And/Or Low BMD
Summary and Conclusions
References
Chapter 46. Estrogen Deficiency, Postmenopausal Osteoporosis, and Age-Related Bone Loss
Introduction
Age- and Sex-Specific Skeletal Changes
Secretion and Metabolism of Sex Steroids
Direct Effects of Sex Steroids on Bone
Indirect Effects of Sex Steroids On Bone
Hormonal Determinants of Skeletal Growth And Maturation
Hormonal Determinants of Age-Related Bone Loss in Women
Hormonal Determinants of Age-Related Bone Loss in Men
The Conundrum of Trabecular Bone Loss in Hormone-Sufficient Young Adults
Other Factors Contributing to Osteoporosis
References
Part VII: Spectrum of Secondary Osteoporosis
Chapter 47. Immobilization Osteoporosis
Introduction
Animal Studies
Cellular and Molecular Mechanisms of Reduced Bone Formation after Unloading
Human Studies
References
Chapter 48. Osteoporosis Associated with Illnesses and Medications
Introduction
Metabolic Disorders
Medications
References
Chapter 49. Glucocorticoid-Induced Osteoporosis
Introduction
Epidemiology of Glucocorticoid-Induced Osteoporosis
Prevention and Treatment
The Pathogenesis and Molecular Basis of Glucocorticoid Action on Bone Metabolism and Development
Other Musculoskeletal Effects of Glucocorticoids
Treatment Options and Fracture Risk Reduction
Management of Glucocorticoid-Induced Osteoporosis in Children
References
Chapter 50. Anticonvulsant-Related Bone Disease
Introduction and Historical Perspective
Epidemiology
Clinical Manifestations
Specific Antiepileptic Drugs
Mechanisms of Action
Treatment
References
Chapter 51. Thyroid Hormone and the Skeleton
Introduction
Thyroid Hormone and Skeletal Growth and Maturation
Thyroid Hormone and Mineral Metabolism
Thyroid Hormone and Skeletal Metabolism
Bone Mass and Fracture Risk in Thyroid Disease
Prevention of Thyroid Hormone-Induced Bone Loss
References
Chapter 52. The Skeletal Actions of Parathyroid Hormone in Primary Hyperparathyroidism and in Osteoporosis
Introduction
Parathyroid Hormone, Primary Hyperparathyroidism, and the Skeleton
Parathyroid Hormone And Osteoporosis
Summary
Acknowledgment
References
Chapter 53. Osteogenesis Imperfecta and Other Defects of Bone Development as Occasional Causes of Adult Osteoporosis
Scope of the Problem
Osteogenesis Imperfecta as a Cause of Adult Osteoporosis
Type I Collagen and Osteogenesis Imperfecta
Clinical Overview of Osteogenesis Imperfecta
Type IV Osteogenesis Imperfecta (Omim 166,220)
Recessive forms of Osteogenesis Imperfecta
Genotype Expression in Osteogenesis Imperfecta
The Pathophysiology of Osteogenesis Imperfecta
Organ Involvement in Osteogenesis Imperfecta
Osteoporosis in the Heritable Disorders of Connective Tissue
References
Chapter 54. HIV and Osteoporosis
Aging and HIV
Etiology of Low Bone Mineral Density in HIV
Other Contributing Factors
Vitamin D Deficiency
Special Populations
Nonskeletal Risk Factors for Fracture
Treatment Considerations
Summary
Reference
Chapter 55. Obesity, Diabetes, and Fractures
Obesity and Fractures
Diabetes Mellitus, Bone Mass, and Fractures
Conclusions
References
Chapter 56. Osteoporosis in Organ Transplant Patients
Skeletal Effects of Immunosuppressive Drugs
Effects of Vitamin D on Immunity and Graft Rejection
Effect of Transplantation on Bone and Mineral Metabolism
Evaluation and Management of Osteoporosis in Patients Awaiting Transplantation
Prevention and Treatment of Transplantation Osteoporosis
Summary and Conclusions
References
Chapter 57. Osteoporosis Associated with Rheumatologic Disorders
Introduction
Rheumatoid Arthritis
Juvenile Idiopathic Arthritis
Seronegative Spondyloarthropathies
Systemic Lupus Erythematosus
Acknowledgments
References
Chapter 58. Osteoporosis Associated with Chronic Kidney Disease
Introduction
Stages Of Chronic Kidney Disease
Epidemiology
Pathophysiology
Skeletal Manifestations Of Chronic Kidney Disease
Extraskeletal Calcifications
Treatment
Hypercalciuria
References
Chapter 59. Oral Bone Loss and Systemic Osteoporosis: Weighing the Risk Benefit Ratio of Treatment
Introduction
Diagnosis
Risk Factors for Intraoral Bone Loss
Patterns of Progression of Oral Bone Loss
Oral Bone Loss and Systemic Osteopenia: are They Related?
Treatment of Oral and Systemic Bone Loss
Bisphosphonates: Risk or Benefit?
References
Part VIII: Cancer and Osteoporosis
Chapter 60. Cancer Treatment-Induced Bone Loss in Patients with Breast Cancer: Pathophysiology and Clinical Perspectives
Introduction
Identifying Fracture Risk in Women With Breast Cancer
Bone Loss in Premenopausal Women Receiving Cancer Treatments
Maintaining Bone Health in Breast Cancer Patients
Disease Modifying Effects of Bone Targeted Treatments
Safety
Conclusions
Acknowledgments
References
Chapter 61. Pathophysiology—Prostate Cancer
Introduction
Normal Bone Physiology
Osteoporosis and Androgen Deprivation Therapy Among Men
Distinction Between Osteoporotic Fractures and Disease-related Fractures
Therapy: Classes of Agents
Clinical Trials With BMD and Fracture End Points
Risk Assessment in Men With Prostate Cancer
Safety of Available Therapies
Conclusions and Recommendations
References
Chapter 62. Mechanisms of Bone Destruction in Myeloma
Introduction
Prevalence and Presentation of Myeloma Bone Disease
The Clinical and Economic Burden of Myeloma Bone Disease
Pathophysiology of Myeloma Bone Disease
Pathogenesis of the Increased Osteoclast Activity in Myeloma
Osteoblast Suppression in Myeloma
Treatment of Myeloma Bone Disease
Conclusions
References
Part IX: Diagnosis and Evaluation
Chapter 63. Evaluation of the Patient at Risk for Osteoporosis
Introduction
Medical History
Physical Exam
Laboratory Studies
Imaging
Invasive Procedures
Treatment Decisions
Conclusions
References
Chapter 64. Imaging of Osteoporosis
Introduction
Principal Radiographic Findings in Osteopenia and Osteoporosis
Diseases Characterized by Generalized Osteopenia
Regional Osteoporosis
References
Chapter 65. Osteoporosis: Who Should be Treated? Who Should be Screened?
Introduction
Who Should be Treated?
FRAX Risk Calculator
Potential Impact of Frax Results
Who Should be Screened for OSTEOPOROSIS—BASED Upon Cost Effectiveness
How Well are Osteoporosis Treatment and Screening Guidelines Followed?
Summary
References
Chapter 66. Clinical Use of Bone Densitometry
Introduction
The Evolution of Bone Densitometry
Dual Energy X-ray Absorptiometry
Other Technologies for the Measurement of Bone Density
The Diagnosis of Osteoporosis Based on the Measurement of Bone Density
Assessing Fracture Risk With Bone Densitometry
FRAX®
DXA-based Vertebral Fracture Assessment
DXA-based Aortic Calcification Assessment
Monitoring Changes in Bone Density After Pharmacologic Treatment
Guidelines for Bone Density Testing
Summary
References
Chapter 67. Biochemical Markers of Bone Turnover in Osteoporosis
Introduction
Biochemical Markers of Bone Formation
Biochemical Markers of Bone Resorption
Analytical and Preanalytical Variability
Clinical Use of Bone Turnover Markers in Postmenopausal Osteoporosis
Bone Turnover Markers in Men
Bone Turnover MARKERS—CLINICAL Studies Versus Clinical Practice
Conclusion: What We Know, What We Need to Know
References
Chapter 68. Fracture Risk Assessment: The Development and Application of FRAX®
Introduction
Development and Construct of FRAX®
Calibration of FRAX®
Performance Characteristics
Reversibility of Risk
Validation
Intervention Thresholds
Interpretation and Limitations of FRAX®
Risk Factors Not Considered in FRAX®
Other Applications of FRAX®
References
Part X: PATIENT MANAGEMENT
Chapter 69. Orthopedic Aspects of Osteoporosis
Orthopedic Aspects of Osteoporosis
Geriatric Fracture Care and Care Treatment Pathways
Osteoporotic Bone and Orthopedic Hardware
Lower Extremity Fractures
Upper Extremity Fractures
Spine and Pelvic Fractures
Osteoporosis and Elective Orthopedic Procedures
Osteoporosis Care in Orthopedic Patients
References
Chapter 70. Falls Prevention Interventions
Epidemiology of Falls and Fall-related Injuries in Older People
Risk Factors of Falls
Fall Risk Screening and Assessment
Fall Prevention Strategies
Summary
References
Chapter 71. Physical Therapy, Physical Modalities, and Exercise Regimens in the Management of Osteoporosis
Introduction
Physical Therapist Practice
Prevention of Fracture
Management of the Patient Following A Vertebral Fracture
Management of the Patient Following A Hip Fracture
Exercise Prescription and Exercise Programs
Conclusion
References
Chapter 72. Calcium in the Treatment of Osteoporosis
Introduction
Cotherapy and Therapy
Bone Remodeling, Osteoporosis, and Calcium
The Critical Role of Protein Intake
Calcium Sources and Amounts
Conclusion
Note
References
Chapter 73. Vitamin D and its Metabolites and Analogs in the Management of Osteoporosis
Introduction
Nomenclature
Vitamin D in the Pathogenesis of Osteoporosis
Animal Models
Postmenopausal Osteoporosis
Other Forms of Osteoporosis
Conclusions
Note
References
Chapter 74. Alternative Therapy through Nutrients and Nutraceuticals
Introduction
Phytoestrogens
Dehydroepiandrosterone
Antioxidants
Bicarbonates
B-Vitamins and Homocysteine
Minerals
Conclusion
References
Part XI: Pharmacotherapeutics
Chapter 75. Design Considerations for Clinical Investigations of Osteoporosis
Background: Inference from Phenomena Subject to Variation
Types of Investigational Designs
Principal Types of Bias with Various Designs
When Controlled Trials and Observational Studies Disagree
Design Alternatives
Design Issues of Special Relevance to Investigation of Bone
Ethics of the Placebo
The Dilemma
Burden of Proof and the Null Hypothesis
References
Chapter 76. Lessons from Bone Histomorphometry on the Mechanisms of Action of Osteoporosis Drugs
Introduction
Anticatabolic Therapies
Anabolic Therapies
References
Chapter 77. Estrogen and Estrogen Analogs for Prevention and Treatment of Osteoporosis
Introduction
Estrogen—The First Osteoporosis Therapy
Estrogen Analogs
Points to Consider
References
Chapter 78. Androgens
Introduction
Androgens
Effects of Testosterone on Bone in Men
Effects of Testosterone on Bone in Women
References
Chapter 79. Calcitonin in Osteoporosis
Introduction
Clinical Pharmacology
Clinical Efficacy in Postmenopausal Osteoporosis
Clinical Efficacy in Other Forms of Osteoporosis
Therapeutic Regimens
Analgesic Effect
Safety
Acknowledgments
References
Chapter 80. Bisphosphonates: Pharmacology and Use in the Treatment of Osteoporosis
Introduction and History
Pharmacokinetics and Pharmacodynamics
Treatment of Postmenopausal Osteoporosis: Efficacy
Bisphosphonate Safety
Bisphosphonate Drug Holidays
Summary
References
Chapter 81. Osteonecrosis of the Jaw and Atypical Femoral Fractures
Introduction
Osteonecrosis of the Jaw
Atypical Femur Fractures
References
Chapter 82. Condition Critical: Compliance and Persistence with Osteoporosis Medications
Introduction
Terminology for Medication-based Behaviors
Compliance and Persistence With Osteoporosis Medications: the Problem
Medication-related Reasons for Noncompliance and Nonpersistence
Compliance and Persistence With Osteoporosis Medications: a Solution(s)?
What Went Wrong? Problems With Recent Interventions
Summary
References
Chapter 83. Denosumab for the Treatment of Osteoporosis
Introduction
Denosumab
Efficacy
Bone Histology and Histomorphometry
Withdrawal of Therapy
Safety and Tolerability
Denosumab in Other Populations
Summary
References
Chapter 84. Strontium Ranelate in the Prevention of Osteoporotic Fractures
Introduction
The Antifracture Efficacy of Strontium Ranelate
The Antifracture Effects of Strontium Ranelate in Specific Populations
Microstructure
Quality of Life and COST-effectiveness
Safety of Strontium Ranelate
Preclinical Studies With Strontium Ranelate
Recent Developments
Conclusion
Conflicts of Interest Statement
References
Chapter 85. Parathyroid Hormone Treatment for Osteoporosis
Introduction
Candidates for Anabolic Therapy
Mode of Action
Postmenopausal Osteoporosis
Parathyroid Hormone (1–84) as Monotherapy
Parathyroid Hormone and Antiresorptive Combination/sequential Therapy
Parathyroid Hormone and Hormone Therapy
Parathyroid Hormone Treatment of MEN
Parathyroid Hormone in Special Populations
Persistence of Effect
Rechallenge With Parathyroid Hormone
Conclusion Regarding Osteoporosis Treatment
Other Possible Clinical Applications for Parathyroid Hormone Treatment
References
Chapter 86. New Approaches to Osteo
- Edition: 4
- Latest edition
- Published: June 13, 2013
- Language: English
RM
Robert Marcus
Dr. Marcus is Professor-Emeritus, Stanford University, where he served on the full-time medical faculty for almost 25 years, before joining the Emeritus faculty in 2001. At Stanford, he was located at the Veterans Affairs Medical Center, Palo Alto California, where he served as Director of the Aging Study Unit of the Geriatrics Research, Education, & Clinical Center from 1982-2001. Dr. Marcus enjoyed a long career as a clinical investigator in the fields of bone and mineral metabolism and osteoporosis medicine. His own research interests included diagnosis and therapy of primary hyperpara-thyroidism, interactions of the parathyroid-vitamin D axis with estrogen, age-related changes in the growth hormone-IGF axis, effects of growth hormone replacement for older men and women, metabolic and musculoskeletal effects of resistance exercise in older men and women, adolescent bone acquisition, and osteoporosis therapeutics. Dr. Marcus’ laboratory was a study site for many of the pivotal clinical trials in the osteoporosis field. These include the NIH Post-menopausal Estrogen/Progestin Interventions Trial (PEPI), Merck’s Fracture Intervention Trial (FIT), Lilly’s Multiple Outcomes of Raloxifene Intervention (MORE), and Lilly’s registration trial of recombinant PTH(1-34) in the treatment of postmenopausal women with osteoporosis. In 2001. Dr. Marcus joined the US Affiliate of Eli Lilly & Company to support Lilly’s program in Osteoporosis and Skeletal Medicine. From 2003 until his retirement from Lilly in 2008, Dr. Marcus was the lead physician for the Forteo team at Lilly. He has published more than 150 research papers, editorials, and reviews. Dr. Marcus served as President of the American Society for Bone & Mineral Research in 2000-2001.
Affiliations and expertise
Professor Emeritus, Department of Medicine, Stanford University School of Medicine, CA, USADD
David W. Dempster
David W. Dempster, PhD, is Professor of Clinical Pathology and Cell Biology at Columbia University in New York. He obtained his PhD from the University of Glasgow in Scotland and completed postdoctoral studies in Switzerland and France. Dr. Dempster is a Past President of the International Society of Bone Morphometry and a member of the Scientific Advisory Council of the National Osteoporosis Foundation. He is also a Fellow of the Royal Microscopical Society. Dr. Dempster’s iconic micrographs of osteoporotic bone have been widely reproduced in the scientific and popular press, including being displayed at the Smithsonian Institution in Washington, DC. Dr. Dempster is an Associate Editor of Osteoporosis International, and serves on the editorial boards of the Journal of Bone and Mineral Research, Bone and the Journal of Clinical Densitometry. His research studies have been continuously supported by the National Institutes of Health for the past 25 years. Dr. Dempster has published over 200 research papers on the pathophysiology and treatment of bone disese.
Affiliations and expertise
Professor of Clinical Pathology and Cell Biology, Columbia University School of Medicine; Director Emeritus, Regional Bone Center, Helen Hayes Hospital, New York, NY, USAJC
Jane A. Cauley
Dr. Cauley, DrPH, is a Distinguished Professor and Executive Vice Chair, Department of Epidemiology, Graduate School of Public Health (GSPH), University of Pittsburgh (Pennsylvania). Her primary research interest is the epidemiology of osteoporosis especially the large worldwide ethnic and geographic variability in fracture, osteoporosis screening and treatment, risk factors for fractures and the consequences of osteoporosis in both men and women. Her research has also focused on women's health and aging, falls, the interaction between endogenous and exogenous hormones, risk factors, and disease outcomes. She was principal investigator for several large cohort studies including the Study of Osteoporotic Fractures (SOF) and the Osteoporotic Fractures in Men (MrOS) study. She is a co-investigator for the Study of Women’s Health Across the Nation (SWAN) with particular emphases on skeletal health and physical function and body composition changes, novel measures of hip strength and the trabecular bone score across menopause. She initiated breast cancer follow-up in SOF and was the first to demonstrate an association between bone mineral density (BMD) and breast cancer, suggesting that BMD could be used as a cumulative measure of lifetime exposure to estrogen.
Dr. Cauley has authored more than 800 papers for scientific journals and 28, book chapters. She co-edited a book entitled the Epidemiology of Aging, published in 2012.
Affiliations and expertise
Distinguished Professor of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United StatesDF
David Feldman
Affiliations and expertise
Stanford University School of Medicine, Stanford, California, USARead Osteoporosis on ScienceDirect